72 articles - From Friday Dec 01 2023 to Friday Dec 08 2023
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Endoscopy |
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Training in basic gastrointestinal endoscopic procedures: a European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement. 9: ESGE and ESGENA recommend that GI endoscopy training units fulfil the ESGE KPIs for endoscopy units and, furthermore, be capable of providing the dedicated personnel, infrastructure, and sufficient case volume required for successful training within a structured training program. 10: ESGE and ESGENA recommend that trainers in basic GI endoscopic procedures should be endoscopists with formal educational training in the teaching of endoscopy, which allows them to successfully and safely teach trainees. |
| J Hepatol |
Improved assessment of donor liver steatosis using Banff consensus recommendations and deep learning algorithms. Our findings support the use of Banff recommendations in daily practice and highlight the need for a granular analysis of their effect on liver transplantation outcomes. Impact and implications • We developed and validated the first automated deep-learning algorithms for steatosis standardized assessment based on the Banff Liver Working Group consensus recommendations. • Our algorithm provides an unbiased automated evaluation of steatosis, which will lay the groundwork for granular analysis of steatosis's short- and long-term effects on organ viability to identify clinically relevant steatosis cut-off for donor organ acceptance. • Implementing our algorithm in daily clinical practice will allow a more efficient and safe allocation of donor organs, aiming at improving the post-transplant outcomes of patients. |
meta-analyses and systematic reviews
| Am J Gastroenterol |
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Dye Chromoendoscopy Outperforms High-Definition White Light Endoscopy in Dysplasia Detection for IBD Patients: An Updated Meta-analysis of Randomized Controlled Trials. Our updated meta-analysis supports DCE as a superior strategy in overall dysplasia detection in IBD, even with HD scopes. When expertise is available, DCE should be considered for surveillance colonoscopy in high-risk IBD patients, with the acknowledgment that virtual chromoendoscopy shows equivalence in recent studies. Further multicenter trials with multiple endoscopists with varying expertise levels and longer-term outcome data showing a reduction in cancer or cancer-related death are needed. |
| Clin Gastroenterol Hepatol |
Lack of Effectiveness of Computer Aided Detection for Colorectal Neoplasia: A Systematic Review and Meta-analysis of Non-Randomized Studies. CADe in colonoscopies neither improves the detection of colorectal neoplasia nor increases burden of colonoscopy in real-world, non-randomized studies, questioning the generalizability of the results of randomized trials. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
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Clinical trial: Clinical and endoscopic outcomes with ustekinumab in patients with Crohn's disease: Results from the long-term extension period of STARDUST. STARDUST LTE is the first interventional ustekinumab efficacy study to show a favourable benefit-risk profile with preservation of clinical and endoscopic outcomes through Week 104 using flexible, algorithm-driven dose adjustment including de-escalation. |
Long-term effectiveness and acceptability of switching from intravenous to subcutaneous infliximab in patients with inflammatory bowel disease treated with intensified doses: The REMSWITCH-LT study. Switching from IV to SC infliximab 120 mg every other week is safe and well accepted leading to low long-term risk of relapse. Tight monitoring and dose escalation should be recommended for patients receiving 10 mg/kg/6 weeks and 4 weeks, respectively. |
Low screening rates and high prevalence of osteoporosis in cirrhosis: A real-world retrospective analysis. A minority of patients with cirrhosis were screened for osteoporosis. The majority screened had osteopenia or osteoporosis on DEXA scan. Less than a quarter of patients with osteoporosis were started on treatment. Real-world experience of oral bisphosphonate use did not reveal higher rates of gastrointestinal bleeding. There is room for improvement in al aspects of bone health care in cirrhosis. |
| Am J Gastroenterol |
Long-term natural history of autoimmune gastritis: results from a prospective, monocentric series. AIG is a progressive disorder, with a virtually absent risk of gastric adenocarcinoma. Potential AIG patients should be monitored as they carry a high risk of evolving into overt AIG. |
The efficacy of metoclopramide for gastric visualization by endoscopy in patients with active upper gastrointestinal bleeding: double-blind randomized controlled trial. Metoclopramide did not improve endoscopic visualization but decreased the need for second look EGD in patients with overall active UGIB. It improved gastric visualization in those with UGIB due to gastric lesions, primarily by improving visualization in the fundus. (ClinicalTrials.gov number NCT04771481). |
| Clin Gastroenterol Hepatol |
Accuracy of the enhanced liver fibrosis test in patients with type 2 diabetes mellitus and its clinical implications. The high diagnostic performance of the ELF test for predicting advanced fibrosis in individuals with or without T2DM could address an unmet medical need for accurate assessment of liver fibrosis in patients with diabetes and NAFLD. |
Cardiovascular Safety of Ozanimod in Patients With Ulcerative Colitis: True North and Open-Label Extension Analyses. No new cardiovascular safety signals were identified, consistent with findings from previous ozanimod studies. There were few major adverse cardiovascular events or thromboembolic events, which were unrelated or unlikely related to ozanimod. Ozanimod has a well-tolerated cardiovascular safety profile when prescribed in accordance with the label. |
Chronic Liver Disease and Cirrhosis Mortality Rates are Disproportionately Increasing in Younger Women in the US between 2000-2020. Mortality rates due to CLD and cirrhosis in the U.S. are increasing disproportionately in younger women. This finding was driven by higher rates in Non-Hispanic White and Hispanic individuals, with variation between U.S. states. Future studies are warranted to identify the reasons for these trends with the ultimate goal of improving outcomes. |
Liver Stiffness Measurement and Risk Prediction of Hepatocellular Carcinoma After HCV Eradication in Veterans with Cirrhosis. LSM predicts rates of HCC in patients with HCV cirrhosis after SVR at multiple cutoff levels and offers a single test to predict portal hypertension-related complications and HCC. Patients with LSM <5 kPa in the absence of diabetes mellitus had a low risk of HCC where surveillance could be discontinued. |
Regression of liver fibrosis in patients on hepatitis B therapy is associated with decreased liver-related events. Antiviral therapy-induced liver fibrosis regression assessed by P-I-R score is associated with reduced liver-related events. This shows the utility of histologic fibrosis regression assessed by on-treatment P-I-R score as a surrogate endpoint for clinical events in patients with HBV-related fibrosis or early cirrhosis. |
Reliability and Responsiveness of Histologic Indices for the Assessment of Crohn's Disease Activity. CD and UC indices were similarly reliable and responsive in measuring histologic CD activity. Exploratory index development did not offer benefit over current histologic instruments. |
| Gastrointest Endosc |
Anesthesia Choice and Its Potential Impact on Endoluminal Functional Lumen Imaging Probe Measurements in Esophageal Motility Disorders. The use sevoflurane-based GAIA for diagnostic EndoFLIP may potentially lead to the misclassification of spastic disorders as Type I achalasia. Therefore, propofol-based TIVA should be considered over sevoflurane-based GAIA for sedation during the diagnostic test. |
Assessing the impact of center volume on the cost-effectiveness of centralizing ERCP. The study's main findings remained unchanged while combining al model parameters in the PSA. Our findings show that HV centers have high-performance rates at lower costs, raising the need to consider the principle of centralization of ERCPs into HV centers to improve the quality of care. |
Association of direct oral anticoagulant and delayed bleeding with pharmacokinetics after endoscopic submucosal dissection. The incidence of post-ESD bleeding taking DOAC was high, especially in aged patients and with high anti-coagulant effects. Measurement of pharmacokinetic parameters of DOACs may be useful in identifying patients at higher risk of post-ESD bleeding. |
ENDOSCOPIC SUBMUCOSAL DISSECTION WITH VERSUS WITHOUT TRACTION FOR PATHOLOGICALLY STAGED T1B ESOPHAGEAL CANCER: A MULTICENTER RETROSPECTIVE STUDY. ESD with traction seems to be associated with higher odds of negative VM than ESD without traction for pathologically staged T1b EC, and future well-conducted prospective studies are warranted to establish the findings of the current study. |
Endoscopic Powered Resection Device for Residual Colonic Lesions: The First Multicenter, Prospective, International Clinical Study. EPR is a safe and effective for benign, persistent, large (>20mm) scarred, colorectal adenomas and should be considered as an alternative treatment in lieu of surgery. Persistence rate of 46.7% show that more than one treatment are necessary for effective endoscopic treatment. |
| Gut |
10-year follow-up results of the European Achalasia Trial: a multicentre randomised controlled trial comparing pneumatic dilation with laparoscopic Heller myotomy. PD and LHM are equally effective even after 10 years of follow-up with limited risk to develop gastro-oesophageal reflux. Based on these data, we conclude that PD and LHM can both be proposed as initial treatment of achalasia. |
Compared to histamine-2 receptor antagonist, proton pump inhibitor induces stronger oral-to-gut microbial transmission and gut microbiome alterations: a randomised controlled trial. Our study provides evidence that PPIs have a greater impact on the gut microbiome and oral-to-gut transmission than H2RAs, shedding light on the mechanism underlying the higher risk of certain diseases associated with prolonged PPI use. |
Dupilumab demonstrated efficacy and was well tolerated regardless of prior use of swallowed topical corticosteroids in adolescent and adult patients with eosinophilic oesophagitis: a subgroup analysis of the phase 3 LIBERTY EoE TREET study. Dupilumab 300 mg once a week demonstrated efficacy and was well tolerated in patients with EoE regardless of prior STC use or inadequate response, intolerance and/or contraindication to STC. |
Integrative multiomics enhancer activity profiling identifies therapeutic vulnerabilities in cholangiocarcinoma of different etiologies. Our study elucidates the mechanisms underlying enhancer dysregulation and deepens understanding of different tumourigenesis processes in distinct CCA subtypes, with potential significant therapeutics and clinical benefits. |
| Hepatology |
ALDOB/KAT2A interactions epigenetically modulate TGF-ß expression and T cell functions in hepatocellular carcinogenesis. Our study has revealed a novel mechanism by which a metabolic enzyme in tumor cells epigenetically modulates TGF-ß signaling, thereby enabling cancer cells to evade immune surveillance and affect their response to immunotherapy. |
Determinants of clinical response to empirical antibiotic treatment in patients with cirrhosis and bacterial and fungal infections- Results from the ICA 'Global study' [EABCIR-Global Study]. Four out of 10 patients with cirrhosis do not respond to the first-line antibiotic therapy, leading to lower resolution of infections and higher mortality. Broader-spectrum antibiotics and strategies targeting systemic inflammation may improve prognosis in patients with high degree of inflammation, low serum albumin levels and severe liver impairment. |
Hyperinsulinemia, an overlooked clue, and potential way forward in metabolic dysfunction-associated steatotic liver disease. The associated fasting hyperinsulinemia has been independently associated as a predictor of major adverse liver outcomes and major adverse cardiovascular events. In this review, we discuss the potential mechanism and entanglement between liver fibrosis and hyperinsulinemia and we hypothesise that the measure of fasting insulin could become a hepatic functional test within the armamentarium of non-invasive tests for the assessment of MASLD. |
Inhibition of CAF-1 histone chaperone complex triggers cytosolic DNA and dsRNA sensing pathways and induces intrinsic immunity of hepatocellular carcinoma. Our findings suggest that CAF-1 is essential for HCC development, targeting CAF-1 may awaken the anti-cancer immune response and may work cooperatively with ICI treatment in cancer therapy. |
UBXN9 inhibits the RNA exosome function to promote T cell control of liver tumorigenesis. Our results reveal a modality in which UBXN9 promotes the stimulatory RNA-induced RIG-I-IFN signaling that induces anti-tumor T cell response in liver tumorigenesis. Targeted manipulation of the UBXN9-RNA exosome circuit may have the potential to reinstate the immune control of liver tumor growth. |
| J Hepatol |
Comprehensive gene profiling of the metabolic landscape of humanized livers in mice. Our work revealed a complex metabolic response landscape of human liver transcriptome and provided a novel resource to understand transcriptome dynamics of human liver in response to physiologically relevant metabolic stimuli ( Impact and implications Direct knowledge of the human liver transcriptome is currently very limited hindering the overall understanding of human liver pathophysiology. We combined a liver-specific humanized mouse model and long read direct RNA sequencing technology to establish a de novo annotation of the human liver transcriptome and identified a multitude of regulated metabolic pathways that were otherwise invisible using conventional technologies. The extensive regulatory information of human genes we provided would allow basic scientists to infer the disease relevance of their genes of interest and physician scientists to better pinpoint the changes in metabolic networks underlying a specific pathophysiology. |
NIS2+TM as a screening tool to optimize patient selection in metabolic dysfunction-associated steatohepatitis clinical trials. While the use of FIB-4 alone did not lead to a significant improvement of the screening process, selecting patients using NIS2+ ™, a recently developed optimization of the NIS4® technology for the detection of at-risk MASH, showed improved performances by simultaneously reducing LBFRs and the overall cost of the trial, keeping a manageable number of patients needed to screen, without generating any bias in included patients' characteristics. This makes NIS2+ ™ an accurate and reliable screening tool for improving the recruitment of patients in future MASH clinical trials, and would lead to increased patient comfort and security, ensuring timely and cost-efficient completion of those trials. |
| J Neurogastroenterol Motil |
Esophageal Motility Abnormalities in Lung Transplant Recipients With Esophageal Acid Reflux Are Different From Matched Controls. The strongest correlation with AET after LT was found to be esophageal peristaltic vigor. These results add to the understanding of reflux after LT and may help tailor an individualized treatment plan. |
The Effect of STW5 (Iberogast) on Reflux Symptoms in Patients With Concurrent Dyspeptic Symptoms: A Double-blind Randomized Placebo-controlled Crossover Trial. We found some indications pointing towards a beneficial effect of STW5 on reflux symptoms in dyspeptic patients, with reduction of esophageal hypersensitivity as a potential underlying mechanism. Our findings will have to be confirmed in larger studies. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Clin Gastroenterol Hepatol |
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misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
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| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
Letters to the editors and authors’ replies
| Clin Gastroenterol Hepatol |
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| Gastroenterology |
| Gut |
| J Hepatol |